Assessment of systolic function and myocardial perfusion after percutaneous coronary intervention in patients with acute myocardial infarction by left ventricular pressure-strain loop
10.3760/cma.j.cn131148-20210715-00475
- VernacularTitle:左心室压力-应变环评估急性心肌梗死患者经皮冠状动脉介入术后心肌收缩功能和灌注水平
- Author:
Yanhong LIU
1
;
Fei WANG
;
Yajuan YANG
;
Yuqiong LAI
Author Information
1. 佛山市第一人民医院 中山大学附属佛山医院心脏功能检查科，佛山 528000
- Keywords:
Pressure-strain loop;
Myocardial work;
Acute myocardial infarction;
Percutaneous coronary intervention;
Myocardial perfusion
- From:
Chinese Journal of Ultrasonography
2022;31(2):115-121
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate left ventricular systolic function and myocardial perfusion in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) by left ventricular pressure-strain loop (PSL).Methods:From August 2020 to December 2020, 47 patients with AMI admitted to the Intensive Care Unit of Cardiovascular Department of the First People′s Hospital of Foshan and treated with PCI were selected. Myocardial contrast echocardiography (MCE) and conventional echocardiography were performed within 72 hours after operation (T1 phase) and conventional echocardiography was repeated 3 months later (T2 phase). Myocardial perfusion scores (MPS) of left ventricular segments were obtained by MCE and the overall myocardial perfusion score index (PSI) was calculated. According to PSI, the patients were divided into good perfusion group and poor perfusion group. Conventional ultrasonic parameters and two-dimensional global longitudinal strain (2D-GLS) were collected. Left ventricular PSL analyzed in off-line EchoPAC software was used to evaluate the left ventricular myocardial work index, including global work index (GWI), global constructive work (GCW), global waste work (GWW), global work efficiency (GWE). The differences of parameters between patients with different perfusion levels and the change of parameters with time at the same perfusion level were compared. ROC curves were used to analyze the diagnostic values of strain parameters and myocardial work parameters in patients with hypoperfusion.Results:There were no significant differences in conventional ultrasound parameters between groups in T1 and T2 phases (all P>0.05), while there were significant differences in 2D-GLS and myocardial work parameters (except GWI in T2 phase) (all P<0.05). The absolute values of 2D-GLS and myocardial work parameters (except GWW ) were higher than those in T1 phase (all P<0.05). There was no significant difference in GWW ( P>0.05), but it decreased in good perfusion group while increased in poor perfusion group over time. ROC curve analysis showed that 2D-GLS, GWI, GCW and GWE had high area under the curve. Conclusions:Left ventricular PSL provides a new sensitive method for the evaluation of cardiac function in patients with AMI after PCI, and is expected to become a new index for the preliminary evaluation of microcirculation.
